Individual
DR. JOHN OLMSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
230070-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02471814
—
NY
05
—
1008655200001
—
PA
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
P00090504
RR MEDICARE
NY
Enumeration date
02/07/2006
Last updated
03/05/2021
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